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Bone Marrow Involvement by More Than One Entity of Hematolymphoid Neoplasm

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Practical Lymph Node and Bone Marrow Pathology

Part of the book series: Practical Anatomic Pathology ((PAP))

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Abstract

A bone marrow biopsy sometimes demonstrates two hematolymphoid neoplasms. In a majority of these cases, a second neoplasm is discovered unexpectedly when examining the marrow for a known or suspected hematolymphoid neoplasm. There are several possible combinations of neoplastic components, but in practice, many cases show a myeloid neoplasm along with a nonmyeloid neoplasm such as plasma cell neoplasm (PCN), chronic lymphocytic leukemia (CLL), other small mature B-cell leukemia/lymphoma, T-cell large granular lymphocytic leukemia (T-LGL), or other T-cell lymphomas. The myeloid neoplasm, usually myelodysplastic syndrome, may occur as a consequence of therapy given for the lymphoid neoplasm, and such cases are covered in Chapter 25. In addition, two different nonmyeloid neoplasms can be seen together, including PCN with CLL, PCN with lymphoplasmacytic lymphoma, CLL with T-LGL, CLL with B-lymphoblastic leukemia, etc. Diagnosis of these concomitant hematolymphoid neoplasms is challenging in that one neoplastic component can potentially mask the other in the bone marrow examination. Here, we highlight the diagnostic approach to correctly identify more than one neoplastic components by using ancillary test on the marrow as well as other laboratory studies, discuss potential etiologies of the concurrency, and emphasize the clinical significance of the phenomenon for treatment and prognosis. Bone marrow involvement by solid tumors, with or without concurrent hematolymphoid neoplasm, is discussed in Chapter 28.

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Authors and Affiliations

  1. Department of Pathology, College of Basic Medical Sciences and the First Affiliated Hospital, China Medical University, Shenyang, P. R. China

    Yue Zhao

  2. Department of Pathology, Duke University School of Medicine, Durham, NC, USA

    Yue Zhao

  3. Department of Pathology, Duke University School of Medicine and Duke Health System, Durham, NC, USA

    Anand Shreeram Lagoo & Endi Wang

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  1. Yue Zhao
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  2. Anand Shreeram Lagoo
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Correspondence to Yue Zhao .

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Editors and Affiliations

  1. Department of Pathology, Duke University School of Medicine and Duke Health System, Durham, NC, USA

    Endi Wang

  2. Department of Pathology, Duke University School of Medicine and Duke Health System, Durham, NC, USA

    Anand Shreeram Lagoo

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Zhao, Y., Lagoo, A.S., Wang, E. (2020). Bone Marrow Involvement by More Than One Entity of Hematolymphoid Neoplasm. In: Wang, E., Lagoo, A.S. (eds) Practical Lymph Node and Bone Marrow Pathology. Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-32189-5_30

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  • DOI: https://doi.org/10.1007/978-3-030-32189-5_30

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-32188-8

  • Online ISBN: 978-3-030-32189-5

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